Long-term Outcomes of Secondary IOL Surgeries Using the Haptic Externalization Scleral Suture Technique

Area of Science:

• Ophthalmology
• Ophthalmic Surgery
• Intraocular Lens Implantation

Background:

• Treating intraocular lens (IOL) dislocation, subluxation, or inadequate capsular support presents surgical challenges.
• Various surgical techniques exist, but their efficacy and complication rates vary.

Purpose of the Study:

• To evaluate the outcomes of the Haptic Externalization Scleral Suture (HESS) technique for IOL fixation in a single surgeon case series.
• To assess the safety and effectiveness of the HESS technique in managing IOL-related complications.

Main Methods:

• Retrospective analysis of 223 consecutive patients undergoing IOL fixation with the HESS technique.
• Data collected included patient demographics, surgical indications, ocular conditions, visual acuity (VA), and intraocular pressure (IOP).
• Postoperative outcomes were assessed at multiple time points up to final follow-up.

Main Results:

• The study included 148 IOL repositioning surgeries, 54 IOL placements in aphakic patients, 12 IOL exchanges, and 9 lensectomies with IOL insertion.
• Significant improvement in VA was observed, from logMAR 1.14±0.05 preoperatively to 0.48±0.04 postoperatively (p<0.0001).
• The rate of IOL dislocation requiring reoperation was 4% (9/223). IOL insertion was associated with higher corneal edema rates (12%) compared to repositioning (3%).

Conclusions:

• The HESS technique is a successful method for correcting IOL subluxation, dislocation, and aphakia.
• IOL repositioning using HESS demonstrates robust VA improvement and low reoperation rates, while minimizing corneal edema risk compared to IOL exchange.